Counseling 174

Describe the basic components of the psychotherpy process. What are the key features? What is the nature of the therapist client relationship?

Psychotherapy is a process of engagement between two people, both of whom are bound to change through the therapeutic venture. This is a collaborative process that involves both the therapist and the client in co-contructing solutions to concerns. Counselors facilitate healing through a process that involves both the therapist is remains the most critical factor affecting the client and promoting change. It is essential that counselors explore their own values, attitudes, and beliefs in depth and work to increase their own awareness.

Cognitive-Behavior Therapy

(A.T. Beck)-thinking as it influences behavior

Family Systems Therapy

(Adler, Whitaker)-key to changing the individual is working with the family

Rational Emotive Behavior Therapy

(Albert Ellis)-highly didactic (teaching with moral objective), action oriented, stresses role of thinking and belief system as root of personal problems

Adlerian Therapy

(Alfred Adler)-growth model that stresses assuming responsibility, creating own destiny, finding meaning and goals to create purpose

Behavior Therapy

(B.F. Skinner)-learning the resolution of specific behavioral problems methods are always being refined

Person-Centered Therapy

(Carl Rogers)-non directive reaction, subjective view of human experience, places faith and gives responsibility to client dealing with problems

Physchoanalytic Therapy

(Freud)-personality development, human nature, focuses on unconscious factors, much attention to first 6 years of life

Gestalt Therapy

(Fritz)-stressing awareness and integration (of body and mind)

Feminist Therapy

(Jean Baker Miller)-focuses on psychological oppression of women, constraints imposed, explores women's identity development, self concept, etc

Postmodern Approaches

(Steve De Shazer)-social constructionism, solution-focused brief therapy, no single truth, but socially constructed realities, client is expert in own life

Existential Therapy

(Viktor Frankl)-reacting against well defined techniques, stresses therapy on basic condition of human existence (choice freedom, responsibility, self determination)

Reality Therapy

(William Glassner)-short term approach bases on choice theory and focuses on client assuming responsibility in the present, learns effective ways to meeting own needs

Critically evaluate this approach, mentioning the main contributions and limitations.

-Cultural-client may prefer more directive approach, individuals accustomed to nonverbal communication may not life direct expression of emotions, internal vx. external locus of control ->individual vs. collectivistic

What are Roger's views on diagnosis and assessment in counseling? How do these figure into the current practice of person-centered therapy?

-Rogers views these to be not useful because they imply the counselor to be the expert -these are currently a necessary evil for most practitioners to correctly/ appropriately involve insurance agencies, used in a less standardized form to build rapport

How is the personal life of Carl Rogers reflected in this theory?

-Rogers was judged much when young, so creating a judgement free environment was important to him

what are your thoughts about the role of assessment in the counseling process?

-a necessary "evil" that work with insurance companies to standardize procedures, these procedure once standardized ensure that nothing is missed physically or mentally, can rule out or become aware of biomedical issues

What are some of the issues that beginning counselors face?

-achieving a sense of balance and well-being -questioning your own competency as you practice technique without supervision -accepting limitations and strengths -managing difficult/ unsatisfying relationships with clients -struggling with commitment and personal growth -developing healthy helping relationships with clients -developing healthy personal boundaries in personal life

What aspects of the person-centered orientation might you integrate into your own perspective? Discuss the concepts that you would want to include as a basic part of your own personal counseling syle

-all aspects can be integrated into any approach, but instead of considering them as absent vs. present, consider them on a continuum to be personally modified as needed

What is the function of assessment and diagnosis in counseling? Do most counselors agree as to the utility of assessment? Diagnosis? What, if any, ethical issues arise when providing assessment and diagnosis in psychotherapy?

-assessment is an ongoing process to help the counselor evaluate key elements of clients psychological functioning; type of theory used dictate whether assessment is used -diagnosis is the process of identifying symptoms which fit the criteria for a specific mental disorder in the DSM-IV-TR -ethical issues; diagnosis my place negative stereotype on the client, assessment may feel mechanistic and not personal

What is Rogers' view of human nature and what are the implications for the practice of counseling? Do you agree with the view of Rogers' view of the actualization tendency?

-at their core humans are trustworthy and positive -humans are capable of making changes and living productive effective lives -humans innately gravitate towards self actualization -given the right growth fostering conditions individuals strive to move forward and fulfill their creative nature

Describe the ways the person-centered approach has been adopted to include areas such as family therapy, education, politics and expressive arts therapy. What distinguishes these adaptations form individual person-centered therapy and from one another?

-because effective therapy has been found to be based on client-therapist relationship, staying with the client instead of moving towards interpretations -the non-person centered therapy approaches require additional interventions to bring change

what are some specific elements of effective multicultural counseling? What must a counselor do to become culturally competent? How might the counselor have to adjust his or her own values to work with clients from differing culture?

-become aware of your own multi-culutreal biases, norms and expectations -try to understand the world through client's vantage point -gain knowledge about oppression, racism, stereotyping, and discrimination -study historical background of client -open to learning from client -develop awareness of acculturation strategies -expand your point-of-view by seeing from clients eyes

What ethical considerations are relevant in a multicultural counseling arena? In what way might our current "westernized" ethical guidelines facilitate or impede the process of multicultural counseling"? How might you as a therapist go about working within existing ethical parameters in a multicultural counseling setting?

-biases could impede the process by: neglecting social/ community factors that focus on individualism, asses with non-normed instruments, judge as psycho-pathological when behaviors are normal for a culture -ask to see the world through clients eyes while exercising congruence and accurate empathy

Differentiate between existentialism and humanism

-both place little value on techniques, clients subjective experiences, trust capacity of client to make choices, require therapist to be fully present -existentialists=people are faced with the anxiety of choosing to create an identity in a world that lacks intrinsic meaning, writings tend to focus on death, anxiety, depression and isolation -humanists (Maslow)=each of us has a natural potential that we can actualize and through which we can find meaning

How is therapist self-care an ethical matter as well as a way to prevent therapist burnout?

-by doing self care we ensure that we are working at our optimal level and better able to treat clients, this also ensures that we do not become depleted over time and are unable to take care of ourselves -by acknowledging counter transferences (harming you or client), cannot expect to open doors for clients that the therapist has not opened for themselves

What arguments can be made in favor of diagnosis? What are some of the reasons to avoid giving clients a diagnosis?

-can be helpful in treatment planning, but avoid for negative stereotype placement

Why is it important for counselors to consider the client's needs before their own when making ethical decisions? What are some of the ramifications of failing to do this?

-cause harm to client, won't have growth promoting environment

What importance is placed on the client/ counselor relationship? Describe the therapeutic conditions necessary and sufficient for personality change to occur. Be sure to clearly define congruence, unconditional positive regard and accurate empathetic understanding. Evaluate the view.

-client, counselor relationship is the most important factor -6 necessary/ sufficient for change to occur: 2 people in psychological contact, therapist is congruent or integrated, client is incongruent, unconditional positive regard for client, accurate empathy for client, to a minimal degree communication is achieved

What does the informed consent process involve? What information must be presented to clients? What is the important in counseling?

-clients need enough info so they can make informed decisions to better select counselors -present info regarding: therapy procedures, risk/benefits and alternatives, right to withdraw from treatment, costs of treatment, supervision, privileged communication, limits of confidentially

Summarize the basic characteristics of the person centered approach

-congruence, unconditional positive regard, accurate empathic understanding

Describe the dimensions of confidentiality in the therapeutic relationship. Are there limits? If so, when do these apply? What are these limits in place? Be sure to clearly define the differences between confidentiality and privilege.

-danger to self or others (5150), elder/ dependent adult abuse, child abuse, hospitalized, court subpoena, client signs release of information -confidentiality is an ethical concept to not disclose info about the client -privileged communication is a legal concept that prevents disclosure of confidential communication in legal proceeding (does not apply to group, couples, family, or child/ adolescent)

In what ways might you use a person-centered base, yet also draw upon other therapy approaches for specific techniques? Explain the importance of developing a sold relationship with a client before you attempt to actively intervene in a client's life with too many techniques.

-developing a solid relationship with a client ensures full disclosure, full disclosure ensures that you have talked about all the dimensions of the client so that all feelings are on the table

Be familiar with the ethical issues associated with dual and multiple relationships in counseling. According to most ethics codes, are dual relationships, by definition inherently unethical? What steps can therapists take to minimize dual relationships in their professional lives?

-dual relationships are not inherently unethical because sometimes they are unavoidable

Why is it essential that counselors follow ethical guidelines? What are these guidelines intended to do? What do you imagine the practice of counseling would be like without the use of ethical guidelines?

-educate counselors on own responsibilities, basis for accountability, protect clients, basis for improving professional practice.

What contributions has Natalie Rogers made to the person-centered approach? Describe her work in expressive arts therapy. How does expressive arts therapy expand upon the person-centered view of human nature?

-expressive art therapy allows to people to express themselves in ways that would be normally more difficult or not possible to do -expands by allowing the conductive environment for change, and having an honest appreciation for the message within the artistic piece

What is an authentic counselor? What attributes does an authentic counselor posses?

-genuine, congruent, non-prototypical/ stereotype

How might personal therapy help counseling students? What are the most important benefits of personal therapy to counseling students?

-helpful because it allows the students to experience the nervousness that a client may feel, can reduce the chance of assuming attitudes, avoiding superiority stance -learns what is helpful and what is not, enhance interpersonal skills, help deal with ongoing stress

Be familiar with the process of ethical decision making in counseling. What specific strategies can you use to make this process easier? Is it always appropriate to strictly follow ethics codes?

-identify the problem, review relevant codes, seek consultation (most important), brainstorm, list consequence, decide and document (2nd most important) reasons for action, include client to degree it is possible -ethics are a guideline in the trust sense of the word, consult if unsure

What are the differences between mandatory ethics and aspirational ethics?

-mandatory ethics are the bare minimum for ethical practice, aspirational ethics are living an ethical professional and personal life

Briefly describe the historical development of the person centered approach. What are some of the changes that have been made to the approach over time?

-person centered therapy is a non-directive therapy that allows clients to find their own answers to their problems that are congruent with their way of thinking, people are assumed to be good, person centered as opposed to problem centered, not a fixed therapy, actualizing tendency

What are the therapeutic goals of the approach? How do the counselors' role and function fit with these goals? What, if any techniques are used in this approach to counseling?

-primary goal is for the client to achieve a greater degree of independence and integration, providing a climate conductive to self actualization -role is to be without roles, attitude of the therapist being more important than knowledge/ skills/ abilities

What are some specific strategies that counselors can take as a way to take of themselves? How is self-care an on going process?

-self care is a form of an assessment which is itself an ongoing process, reflecting on personal opinions/ biases can be beneficial

What are you concerns pertaining to boundary issues in professional relationships? What thoughts do you have about how you can go about establishing appropriate boundaries with your clients? What connection do you see between your ability to establish personal boundaries and boundaries professionally?

-setting boundaries early on, and as they bear repeating is the most ethical -if you are applying aspirational ethics to your life, then this includes practicing safe/ normal boundaries depending on the person and situation, this includes professionally and personally -boundary crossing (p. 51)

What are the signs of burnout and how might burnout be treated or prevented?

-signs=physically draining, psychologically depleted -prevent by self monitoring or self care (assessing your own life), incorporate wellness perspective

How do a counselor's personal values impact the therapeutic treatment with their client? Be sure to define value imposition and comment on its effects on counseling.

-strive for being value-neutral with the realization that it is not 100% possible -value imposition=how your values influence your interventions and clients therapeutic experience

What are some contributions and limitations of concepts of the person-centered approach as applied to multicultural counseling? In what ways might you modify the techniques you are depending on the client's cultural background?

-switch to motivation interviewing as the client may be going to you as a last/ only choice, so a more direct approach may be necessary for safety of client -rephrasing questions to ask the client how their respective culture/ community feels

How does an effective counselor stay alive as a person and as a professional?

-take care of your single most important instrument (you) -know what causes, how to recognize, remedy and prevent burnout

What are some of the challenges associated with obtaining informed consent form clients?

-telling clients what you are required to disclose for may discourage the patient form disclosing those things

Discuss the concept of accurate empathy as the therapist's ability to subjectively understand the client's world. What are some barriers that might limit a therapist's capacity to be empathic? What are some of the common misconceptions about what constitutes accurate empathic understanding?

-the ability to deeply grasp the clients subjective world -helper attitude more than knowledge (therapist need not experience that situation themselves) -culture/ gender/ socio-economic barriers -doesn't mean you have to have experienced the situation yourself

Describe the application of the person-centered approach to group counseling. What are the goals of person-centered group counseling? What is the role of the leader and of the members?

-to create a safe/ healing climate, where group members can interact in honest ways -role of the leader is to facilitate, members should make process observations and reflect on what's being said

How does a counselor go about interpreting ethical guidelines?

-to determine counselor neglect, the case is decided by a majority vote of counselors acting in a similar fashion

Define evidence-based practice. What are the advantages and disadvantages of this treatment modes? What are the ethical considerations associated with evidence-based practices?

-using specific interventions for specific problems and empirically based diagnosis -advantages: treatments validated empirically, treatments brief and standardized, preferred by insurance companies, calls for accountability for effective treatment with mental health professionals -disadvantages: mechanistic and doesn't allow for individual differences, not well suited for clients with existential concerns, difficult to measure both technical and rational aspects, has potential misuse as means for cost containment

What are the key features of an effective counselor?

-you are your most important instrument, model of person struggle for living up to potential -be authentic (mom-stereotyped/ professional role) -be a therapeutic person (clear about who you are, to risk, to care, and be involved)

Discuss the research base that supports the person-centered approach? How was Rogers' willingness to test his hypotheses important in the development of psychotherapy research? In what specific areas has the person-centered approach to counseling been studies?

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What is the value of personal therapy for the counselor? How does this process contribute to the professional development of the counselor? How do most counselors feel about this process?

can consider your motivations, find support as you struggle, have help with issues opened as you work with clients -most counselors feel that, it is personally beneficial, and important for their professional development

What are the areas of Stan's strength and weakness?

enjoy psychology and construction (satisfying), wants to help people (was helped), family loves him, shady past behind him, willing to take risks, supervisor at youth camp had confidence in him, believes in himself, successful as auto-mechanic

What are some of Stan's presenting problems?

getting along with people/making friends, problem drinking, existential issues, social anxiety, regret, worried about intelligence, worried around women (how manly he is), suicidal thoughts, hasn't lived up to family's expectations, depressed, sexual difficulties, parents fought a lot, compared to siblings unfairly, used drugs and sent to youth rehab, expelled from regular school

Describe the research findings regarding treatment outcome of psychotherapy. What factors are the most important and why?

most important factor is the client-therapist relationship, with the most important tool being the therapist, and they therapy type used -client-therapist relationship most important because it is required to build good rapport with the client, and build a trusting environment

What issues do you expect to be prominent in his treatment with Jerry Corey?

wants to start feeling good about himself, wants to stop drinking, wants to enter a relationship, become less fearful of women, feel as an equal to others, less anxious and guilty, become a good counselor for kids, trust people

With what kinds of populations do you think this approach has the most applicability?

western, white